Authors: Siyu Qian, China and Li Mingjiang, RSIS

China has had a rollercoaster experience in dealing with the COVID-19 pandemic after the relaxation of the COVID-zero policy. While the situation now has gradually returned to normal, the first few weeks since China reopened on 7 December 2022 were extremely difficult for millions of people in the country.

Many cities were crowded by people waiting outside pharmacies to buy cold and flu medicines. Even more people spent hours every day searching for medicines online. Medicines were often out of stock at local pharmacies and online prices have soared to an astonishing level.

There was chaos in numerous Chinese hospitals in the early days of Reopening. Many medical service providers, who reportedly had not been informed of the hasty reopening, fell prey to the first wave of infections. Patients with severe COVID-19 symptoms could not receive timely medical treatment either because ambulance services were overburdened or there were not enough hospital beds. Information about the surge of deaths associated with COVID-19 infection, especially in some big cities, was widely circulated online.

Complaints were pervasive on Chinese social media. People expressed their sadness and bitterness in their online New Year messages. Many people were very critical of the government authorities’ failure in making proper preparations before reopening. The negative impacts of such impromptu decision-making and governance have added to the grievances that manifested in 2022 when lockdowns and draconian social restrictions were the usual responses under the zero-COVID policy.

Days before the reopening, state media outlets were still advocating for a zero-COVID policy while stressing the need to strike a balance between implementing restrictive measures and minimising damage to normal socioeconomic activities. No one expected such abrupt abandoning of the zero-COVID policy and the embracing of a fatalistic ‘lying flat’ approach that the Chinese media had lambasted Western countries for pursuing.

Greater coordination and preparation in advance would have allowed the population who were affected by the first infection wave to have better coped with these challenges. While it may be unrealistic to dramatically increase capacity at hospitals, especially in a short period of time, it was puzzling why there would be a severe shortage of medicines given that China is a major manufacturer of drugs. For example, China’s production capacity of Ibuprofen is approximately 14,000 tonnes per year — almost one third of global output.

Medicine shortages stemmed from China’s slow policy adjustment inadequate preparation for reopening. Over the past three years, the government seriously restricted the sales of cold-related medicines at pharmacies to find and monitor positive COVID-19 cases. This resulted in pharmacies being reluctant to stock these medicines and led to the significant production drop.

Decision-makers should have known that it takes time for companies to resume their production lines, recruit workers and purchase raw materials to mount an adequate response to booming consumer demands immediately after the reopening. The drug shortage problem could have been avoided if the government had alerted large pharmaceutical enterprises ahead of reopening and given more thought to the distribution of medicines in advance.

This problem was compounded by the general public’s panic and fear when reopening was announced. Some people panic bought medicines to build a sense of reassurance under such circumstance. As a result, people infected with COVID-19 had no or very limited medicine to cope with their symptoms.

Chinese authorities also failed to plan to supply some anti-COVID oral drugs before reopening. It took almost three weeks after the reopening for Paxlovid to be provided at hospitals and clinics in Beijing. The availability of Paxlovid at Chinese hospitals is still quite limited. Black market price gouging saw a box of Paxlovid costing between about US$400 and over US$2000 during the first few weeks post reopening.

The reopening is not the first time that impromptu and even campaign-style policymaking has been seen in China. The widely popular anti-corruption effort has seen several rounds of campaigns against some of the ‘big tigers’. But critics have argued that institution-building to address the root causes of corruption has been insufficient. The heavy-handed crackdown on some leading information technology companies has led to significant layoffs in this sector. The swift decision to limit and ban tuition facilities and private education resulted in anxiety that people would lose their jobs overnight.

Many observers of Chinese politics do not think that the negative consequences of the abrupt reopening will reduce the impulse of campaign-style decision-making and governance in the future. The logic underlying this type of governance is intrinsically related to the new political dynamics that have taken root in the country over the past decade.

Siyu Qian is an independent analyst based in China.

Li Mingjiang is an Associate Professor at S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University, Singapore.

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